How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,698 to $8,913Professionalmedian $1,549 · 10th to 90th $1,072 to $1,950
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2,884.03 Median $4,466.84 Typical High $7,762.47 | Facility | None | $2,884.03 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $1,949.84 | Professional | None | $977.24 | $1,380.38 | $1,949.84 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,344.23 Median $4,168.69 Typical High $9,120.11 | Facility | None | $2,344.23 | $4,168.69 | $9,120.11 |
BCBS Idaho Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $1,905.46 | Professional | None | $1,479.11 | $1,778.28 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $2,884.03 | Facility | None | $1,905.46 | $2,137.96 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,412.54 | $1,659.59 |
Moda Health Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,413.10 | Facility | None | $1,122.02 | $2,754.23 | $7,413.10 |
Moda Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,737.80 Typical High $1,949.84 | Professional | None | $1,258.93 | $1,737.80 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,380.38 | $1,698.24 | $1,698.24 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,951.21 | Professional | None | $1,698.24 | $1,698.24 | $2,951.21 |
Regence BlueShield Setting Facility Modifier None Typical Low $6,025.60 Median $8,912.51 Typical High $11,481.54 | Facility | None | $6,025.60 | $8,912.51 | $11,481.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,862.09 | Professional | None | $1,479.11 | $1,479.11 | $1,862.09 |
Select Health Setting Facility Modifier None Typical Low $812.83 Median $831.76 Typical High $6,456.54 | Facility | None | $812.83 | $831.76 | $6,456.54 |
Select Health Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,230.27 | Professional | None | $812.83 | $812.83 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $3,388.44 | Facility | None | $1,698.24 | $2,238.72 | $3,388.44 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,412.54 Typical High $1,995.26 | Professional | None | $1,000.00 | $1,412.54 | $1,995.26 |
21 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $588.84 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $234.42 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $870.96 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $177.83 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $117.49 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $812.83 | $1,348.96 | $1,348.96 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,621.81 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,380.38 | $1,621.81 | $1,737.80 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $181.97 Typical High $190.55 | Professional | 55 · Aftercare only | $154.88 | $181.97 | $190.55 |
BCBS Idaho Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $1,148.15 Typical High $1,202.26 | Professional | 62 · Two surgeons | $954.99 | $1,148.15 | $1,202.26 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $1,819.70 Median $2,187.76 Typical High $2,290.87 | Professional | 63 · Small infant | $1,819.70 | $2,187.76 | $2,290.87 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,258.93 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,258.93 | $1,348.96 |
BCBS Idaho Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $288.40 Typical High $309.03 | Professional | 80 · Assistant surgeon | $245.47 | $288.40 | $309.03 |
BCBS Idaho Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $245.47 Median $288.40 Typical High $309.03 | Professional | 81 · Minimal assistant surgeon | $245.47 | $288.40 | $309.03 |
BCBS Idaho Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $245.47 Median $288.40 Typical High $309.03 | Professional | 82 · Assistant surgeon, no resident | $245.47 | $288.40 | $309.03 |
BCBS Idaho Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $245.47 Typical High $263.03 | Professional | AS · PA/NP assist | $208.93 | $245.47 | $263.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $630.96 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $630.96 | $977.24 | $977.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $251.19 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $954.99 | $1,445.44 | $1,445.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $190.55 | $288.40 | $288.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $125.89 | $194.98 | $194.98 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $891.25 | $1,348.96 | $1,348.96 |
Where Idaho sits
The same service costs 5.9 times more in Oklahoma than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Idaho· 12th of 51
$1,820
OK $4,074UT $692
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.